Pennsylvania residents may choose from 26 Medicare Part D prescription drug plans offered by 14 separate health care companies. These companies make their offerings under the supervision of the federal government’s Medicare program, which may help offset the rising costs of prescription drugs in your local area. To sign up for a Part D plan, you’ll need to be enrolled in Original Medicare Part A and Part B. Once that’s done, you may apply to the Part D plan of your choice via the provider company’s website or in person.
Make sure to apply as soon as you’re eligible. Failure to do so could end up costing you substantial late fees, increased monthly premiums, and even health audits that may affect your coverage.
Medicare Part D vs. Medicare Advantage
Medicare Advantage also provides prescription drug coverage in some cases, but it differs from Part D that focuses specifically on drugs. Advantage plans (also known as Medicare Part C) offer a broader range of coverage options since they are designed to replace Original Medicare Parts A and B. They vary widely in pricing, coverage, and availability in comparison to Part D plans, so it’s important to do your research when selecting either a Part D plan or an Advantage plan to meet your prescription drug needs.
It’s also worth noting that some Advantage plans are not compatible with Part D, meaning that when you enroll in Part D, your Advantage plan will be cancelled and you will be reverted back to Original Medicare Part A and Part B. You should speak with the administrator of any Advantage or Part D plan that you are considering and ensure that any changes you make will not invalidate your current insurance coverage.
When to sign up
The sign-up process is time-sensitive, so you’ll want to make sure that you take advantage of the Initial Enrollment Period. This period starts three months prior to your Original Medicare eligibility date and ends four months after the same date. This gives you a total of seven months to research Part D plans and complete the application process. Your Original Medicare eligibility date is based on your birth month and your 65th birthday.
If you fail to apply to a Part D plan during the Initial Enrollment Period, you can try again during the Annual Election Period. This period starts on October 15th of each calendar year and concludes on December 7th of the same year. If you can’t apply by this time, you can petition Medicare for inclusion in one of its Special Election Periods. These periods are typically provided to assist people with hardships, so it’s better to apply during one of the earlier periods if at all possible. The longer you wait, the greater your chance of a health audit, late fees, and higher monthly premium costs.
What are my choices?
The Medicare Part D services listed in the preceding table are provided in all of Pennsylvania’s counties. Your county of residence may provide additional plans and services. Contact one of our representatives or your local Medicare office for additional details.
Plans are subject to change as contracts are finalized.
Includes contracts/plans as of April 22, 2016. The data does not reflect information for employer-sponsored plans, Part B-only plans, or plans not offering a Part D drug benefit.